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Home My WebLink AboutPermit Electrical 2010-11-1 Electrical Permit Application - 225 Fifth Street. Springfield, OR 97477. PH(541)726-375H FAX(541)726-3689 o _ ':' . DE~_tIHMENt U~E ONL. Y /,7/0 f:-. LD Permit no.: ~ .--'0 II)) ho I , Date: This permit is issued under OAR 9]8-309-0000. Permits are nontransferable. Permits expire if work is not started within ]80 days of issuance or if work is suspended for ]80 days. ,. ,o';!.fOCAL:GOVERNMENT iAp,PB.OVAIJ;;(,,~~;fi";~~.\K'. Zoning approval verified? 0 Yes 0 No ;:,,',{CATEGORY:~OI7ACONSTRUCTIONl';;'Ti: . D Residential D Government Commercial ~~~.:J_OB1ISIIPE:~INEORMATIQNi'{AN[')~jL.QCAJ!ION(Q1r'!\i<j!\~: . Job site address: 7'10 6? :'I1;u City:~ Reference: ZIP: '1 'I ? cJ Fax: Phone: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OARI 479.540(1) and 479.560(1). CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: .~'v~ ~~ ~ 440.2584-J (9108/COM) ,~ ',' . o' ~~0*~~~~~~~~~~F.EE~SCHEPQBE~X~~4~~~*~~4~~~~ .' ,"0" ,",'.. >' :!=oS! Total ;Num~ero.finipection~p~rjte.m'(')'i' Qty: . , .. ,. ,'., . - . " ',' . _ - '. . '"'; 'oj'. '~ ..' ''''', ", f" ,'. . ._.' ~ < '.,' _ -" .'!_;ea< , cost. '.- Residential, per unit, service included: 1,000 sq, ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, a~teration, relocation 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ 401 to 600 amps (2) $158.00 $ 601 to 1.000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: insta1!ation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87.00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, e.xtension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit I $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee; First branch circuit (2) \ $ 55.00 $ C;" ..", Each additional branch circuit , $ 6.00 $ , ( ) Miscellaneous fees: service or feeder tlot included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (I) $58.00 $ fi~~;~~~l~nifl'~J\i~~\~'Rf?i}iCANT~;iU$ER~J,~ri;t~i;:01~~T~Sf~~:?:, :>~; (A) Enter subtotal of above fees I (Minimum Permit Fee $58.00) $ L" (B) Enter 12% surcharge (.12 x [AD $ 7 .53:- (C) Technology Fee (5% of [AD $30'_ TOTAL rees and surcharges (A through C): $ '71 3'7 -.-. CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00620 IVR Number: 811137666654 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 11/01/2010 11/01/2010 11/01/2010 SITE ADDRESS: 770 HARLOW RD, APT# 110, Springfield, OR 97477-1132 ASSESOR'S PARCEL NO: 1703223402800 225 Fifth 51 5pringfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us EXPIRES: VALUE: 04/30/2011 $0.00 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Electrical Only Alteration Commercial PROJECT DESCRIPTION: Add I Alter 2 circuits Phone Number: OWNER: ADDRESS: SUN RETIREMENT CORPORATION 200 HAWTHORNE AVE SE A-140 SALEM OR 97301 CONTRACJOR INFORMATION ~ Contractor :rype Contractor Name COMPLETE ElECTRICAL INSTALLATIONS INC Lie Type CCB # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alanns: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: , Residential Specialty Code Edition: Structural Specialty Code Eilition: Lic No 184274 Lie Exp 10/14/2012 Phone 541-225-7827 Lot Size: Sq Ft 1 st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Fl Garage: Sq Ft Carport: Sq Ft Other: 0 p...,........'":~ Occupancy Load: .". IIUIV: Oregon law re . f. :~.,2008.les adopted b the qwres you to ku!dication Center Th Y Oregon Utility in OAfl952-001_001 0 t~r~~r~es are set torth 0090. You ma obt . .9 OAR 952-001_ calling the c~nteram(~ootPI.etshOf the rules by numb f . e. e telephone er or the Oregon Utility Notifi . Center is 1-800-332-2344). cation Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 11/1/2010 1:52:18PM Page 1 of 3 SP.RINGFIE~.~ . ~H_" : ..... itJi d';~d" OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00620 IVR Number::811137666654 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 11/01/2010 ISSUED: APPLIED: 11/01f2010 11/01/2010 EXPIRES: VALUE: 04/30f2011 $0.00 SITE ADDRESS: 770 HARLOW RD, APT# 110, Springfield, OR 97477-1132 ASSESOR'S PARCEL NO: 1703223402800 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Electrical Only Alteration Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Add / Alter 2 circuils DEVELOPMENT INFORMA TION ~ ' Overlay Dist: # Street Trees.Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: SUbdivision Accepted: Note~: Sidewalk Type: Downspout/Drains: Valuation Description ~ Descriotion . Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ Descriotion Branch circuits without service or feeder - 1 st circuit Branch circuits without service or feeder - each additional State of Oregon Surcharge (12% of applicabl~ fees) Technology fee (5% of permit total) Total Amount Paid Amount Paid $55.00 $6.00 $7.32 $3.05 $71.37 Date Paid 11/01/2010 11/01/2010 11/01/2010 11/01/2010 Receiot # 374761 374761 374761 374761 Springfield Building Permit 11/1/2010 1:52:18PM Page 2 of3 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00620 IVR Number: 811137666654 www.ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: Issued 11/01/2010 ISSUED: APPLIED: 11/01/2010 11/01/2010 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield,or.us EXPIRES: VALUE: 04/30/2011 $0.00 SITE ADDRESS: 770 HARLOW RD, APT# 110, Springfield, OR 97477-1132 ASSESOR'S PARCEL NO: 1703223402800 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: Electrical Only Alteration Commercial PROJECT DESCRIPTION: Add / Alter 2 circuits Plan Review ~ DeDartment Application Acceptance Received Due Date ComDleted Result 11/01/2010 11/01/2010 11/01/2010 Over the Counter Initial Review 11/01/2010 11/01/2010 11/01/2010 OverlheCounler Reviewer Chris Carpenter Chris Carpenter INSPECTIONS REQUIRED ~ Inspections 4500 Rough Electrical 4999 Finai Eleclrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shaff be done in accordance with the Ordinances of the Cily of Springfield and Ihe Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the perty, and the approved set of plans will remain on the site at all times during construction. -1)- 1-/0 Date Springfield Building Permit 11/112010 1:52:18PM Page 3of3 SP~N:. FIE~~... . ~'''. .~.~. '<"'OREGON WWI/ .ci. spri ngfield, or ,us TRANSACTION RECEIPT 811-SPR2010-00620 770 HARLOW RD APT 110 CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 permitcenter@cLspringfield.or.us RECEIPT NO, 201000071 9 RECORD NO, 8 I I.SPR20 I 0-00620 DAn:, 11/01/2010 rDE~CRII'"tLQtl"'~ 'i'.e''', cf:E;":'~' .":';; ,;,<'; '",i;:Ac,<::,QUNftc,QOE:;%;,:;.' '. ;i'P,;M()_lJNjj::,-U~_;' .___J Branch circuits without service or feeder -1st circuit 224-00000-426102 $55.00 Branch circuits without service or feeder - each additional 224-00000-426102 $6.00 State of Oregon Surcharge (12% of applicable fees) 821-00000,215004 $7,32 Technology fee (5% of permit total) 100,00000-425605 $3,05 TOTAL DUE: $71.37 LPAYMENT, TYPE lS,.2:,'4iPAYOR ';~cA~~iER".cCA~PENrERF;llCO.MM~Nt$'~;f Y:"", ,I;;':~{:;,,'j, AMOUNTipAID.. ., ..1 Credit Card 071731 COMPLETE ELECTRICAL INSTALLATIONS INC $71,37 $71,37